Edeloss is a combination drug, containing a short-acting loop-diuretic, Frusemide and a long-acting aldosterone antagonist, potassium-sparing Spironolactone. Preparation of these two, shows complementary mechanism of action to result in a powerful diuretic effect. Frusemide inhibits Na+/K+/2Cl- co-transport at loop of Henle and there occurs inhibition of electrolyte and water reabsorption and Spironolactone acts on collecting tubule to block the aldosterone receptors competitively thus inhibiting sodium retention and potassium secretion. As a result sodium excretion is largely enhanced & loss of potassium is suppressed thus a total positive effect on diuresis is achieved.

Indications

• Essential hypertension

• Chronic congestive heart failure

• Hepatic cirrhosis, with collection of fluid in the abdominal cavity (ascites)

Generally, this combination preparation is well tolerated. However, a few side effects like nausea, malaise or gastric upset, headache, hypotension, skin rash may be seen which disappears after withdrawal of the drug.

Precautions

Caution should be taken in patients liable to electrolyte deficiency. This preparation should also be used with caution in diabetes, enlarged prostate, hypotension and in hypovolemia.

Contraindications

The combination of Frusemide and Spironolactone is contraindicated in patients with acute renal failure, renal insufficiency (creatinine clearance: <30ml/min), anuric states, hyperkalemia, hyponatremia, addison\'s disease or in patients with hypersensitivity to Frusemide, Spironolactone or Sulphonamide. It is also contraindicated for children.

Use in Pregnancy & Lactation

Pregnancy: There is clinical evidence of safety of Frusemide in pregnancy but Spironolactone may cross the placental barrier. So it should be used in pregnancy only if strictly indicated & for short-term treatment and if expected benefits to the mother is greater than the possible risk to the fetus.
Lactation: It is contraindicated in lactating mother.

Drug Interaction

Precautions should be taken while co-administration with the following drugs: ACE inhibitors, nephrotoxic & ototoxic antibiotics, corticosteroids, NSAIDs, carbenoxolone and sucralfate.

Overdose

Symptoms of overdosage include drowsiness, mental confusion, dizziness, diarrhea and vomiting etc. due to excessive diuresis. Treatment should be aimed at the replacement of fluid and correction of any electrolyte imbalance.